Imaging Algorithm for Discitis, Epidural, and Paraspinal Infection

Abstract

This article discusses imaging algorithms in early diagnosis of vertebral osteomyelitis-discitis, which, given its often vague clinical presentation, poses a diagnostic challenge. Magnetic resonance imaging, given its high sensitivity and specificity and capability to deliver exquisite anatomic details, plays a crucial role in its early diagnosis. A high accuracy can also be achieved by using a combination of other modalities, including a variety of nuclear medicine studies, which is especially important in patients who cannot tolerate magnetic resonance imaging. Computed tomography-guided biopsy is being increasingly recognized as a valuable tool in diagnostic work-up of vertebral osteomyelitis-discitis.